Nurse Educators and Practitioners Journal
The Nurse Educators and Practitioners Journal (NEPJ) is a triannual peer-reviewed publication of the Nurse Educators and Practitioners Guild, Inc. (NEPraGuild, Inc.), based in Baguio City, Philippines. The journal is dedicated to bridging the gap between nursing education and clinical practice by disseminating quality, evidence-based research and scholarly works. NEPJ publishes original studies, reviews, and practice-oriented articles that advance nursing education, enhance clinical practice, and contribute to the development of the nursing profession across diverse healthcare and academic settings.
Nurse Educators and Practitioners Guild, Inc.
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Healthcare Beyond Earth: A Literature Analysis on “Aerospace Nursing”
“Aerospace Nursing” is an emerging interdisciplinary field focused on addressing healthcare challenges in air and space travel, extreme remote environments, and analog missions. This analysis of 45 studies from 1975 to 2024 covers four research objectives: (1) identifying clinical and operational challenges, (2) evaluating required skills and training, (3) assessing nurses’ roles in crew well-being and safety, and (4) informing educational frameworks. A conceptual framework based on the nursing metaparadigm (“Person,” “Environment,” “Health,” and “Nursing”) with moderators (“Education,” “Training,” and “Research”) guide the analysis. Findings demonstrate physiological, psychological, and ethical issues, establish the need for trauma care and telehealth competencies, and recognize nurses’ critical contribution to mission safety. Gaps related to standardized curricula and the feasibility of adapting Earth-based nursing to space settings are identified. The analysis provides implications for practice, education, and policy, supporting the development of “Aerospace Nursing” programs.
Copyright (c) 2025 Author https://creativecommons.org/licenses/by-nc/4.0
Values-Driven Adaptive Leadership among Millennial Filipino Nursing Deans: A Descriptive Phenomenological Study
Introduction: Millennial deans (born 1981–1996) are increasingly visible in Philippine nursing education and are helping steer programs through accreditation, curriculum reforms, and workforce well-being concerns. Operating within culturally hierarchical institutions, these leaders describe anchoring decisions in values while adopting participatory and context-attuned approaches to change. Despite their growing presence, little is known about how these deans form and negotiate leadership identity as they assume the role, enact adaptive strategies in governance and day-to-day decision-making across diverse stakeholders, and cope with institutional and intergenerational pressures to sustain effective leadership. Aim: This study aimed to describe the essence of the lived experience of Filipino millennial nursing deans, focusing on leadership identity formation, adaptive leadership strategies in governance and decision-making, and coping mechanisms for institutional and generational challenges. Methods: Guided by Husserlian descriptive phenomenology, ten purposively selected millennial nursing deans from CHED-accredited Philippine institutions participated in in-depth semi-structured interviews. Data were analyzed using Colaizzi’s method, ensuring credibility through member checking, peer debriefing, and strict adherence to ethical standards. Results: Analysis revealed six major themes: (1) Thrust into Deanship Without Support, (2) Proving Legitimacy and Bridging Generational Differences, (3) Shared Governance, (4) Work-Life Balance, (5) Managing Vulnerabilities through Grit, and (6) Values-Driven and Adaptive Leadership. Intergenerational conflicts, emotional labor, sudden appointments, and a lack of mentorship were all mentioned by the participants. In spite of these obstacles, they showed tenacity and promoted inclusive, introspective, and wellness-focused leadership styles. These findings reveal that personal values and contextual adaptation are dynamically integrated into their leadership practices, reflecting key aspects of what can be called an adaptive-values approach. Conclusion: Filipino millennial nursing deans navigate institutional and generational challenges by combining adaptive strategies firmly anchored in individual and group values, advancing culturally responsive academic governance practices. This study's insights offer crucial direction for creating leadership frameworks, mentorship programs, and organized succession planning that are suited to the particular generational and contextual requirements of nursing education.
Research Competency of Professional Nurses
Background: Nurses face increasing demands for high-quality care, driven by local and global health advancements. This necessitates research and the adoption of evidence-based practices to enhance both nursing care and the profession itself. The literature reports the lack of understanding and accessibility of research related to the research capability of nurses. Collaborative nursing research across academic and practice settings is imperative to generate knowledge to improve patient care; however, models of academic/practice partnerships for nursing research are lacking. Aim: This study determined the research competency of professional nurses to serve as a basis for the development of research-based activities. Methods: Utilizing a quantitative descriptive survey design, with the use of a questionnaire and structured small group interview (4 small groups with 3-4 members per small group), data were gathered from 81 nurses employed at hospital X, which is a 250–bed capacity tertiary hospital. The self-made structured questionnaire is valid with a CVI=0.956. Frequency, percentage, mean, and the Kruskal-Wallis test were used to treat the data statistically. Findings: Majority of the respondents belong to the younger population (87.66%) belonging to less than 2-5 years of service in the institution. Respondents are advanced nurse researchers (mean=1.95) and have been serving as respondents in research (50.00). The respondents had the highest mean =2.02 in problem identification and the lowest in research utilization with a mean=1.90. The research competency of nurses is significantly associated with educational attainment, with a p-value of 0.011. Position (p value=0.387), length of service (0.210), area of assignment (p value=0.449), and research involvement (p value=0.169) are not significantly associated with their research competency. Conclusion: Based on the findings of the study, the researchers conclude that nurses who are employed at Hospital X possess the knowledge; however, they lack the practical experience in research. The variable of educational attainment is an important factor in achieving research competency. There are personal, organizational, and professional facilitators and barriers to the research competency of the nurses. A research capability enhancement program for the nurses can be developed. The researchers recommend: enhancing the research competency of the nurses through a research capability-building program developed for them; strengthening the institutional support for ongoing research training, especially for the nurses who are pursuing their postgraduate education or continuing professional development in the research process; recognizing and rewarding research engagement and output among nursing staff to sustain high-level performance; the promotion of mentoring systems where expert and proficient nurses can guide those still developing their research competencies, and the conduct of future studies involving multiple institutions to broaden generalizability and include more inferential analysis.
Adherence to Medication Regimen and Awareness of the Local Government Support Program Among Employees Diagnosed with Hypertension in a Selected Company
Introduction: This study assessed the medication adherence and awareness of Local Government Unit (LGU) support programs among employees diagnosed with hypertension in a selected company. It examined the relationship between awareness and adherence and identified key factors influencing these behaviors to inform workplace and public health strategies. Method: A descriptive-correlational design was used involving 103 purposively selected employees. Validated tools were utilized, including the Morisky Medication Adherence Scale (MMAS-5), a researcher-made LGU Awareness Scale, the Beliefs about Medicines Questionnaire (BMQ), and the Multidimensional Scale of Perceived Social Support (MSPSS). Data were gathered between April and May 2025 and analyzed using descriptive statistics, chi-square tests, Spearman’s Rho, and multiple regression. Results: The medication adherence was moderately high (M = 3.01), especially in following scheduled doses, but declined when symptoms improved or side effects occurred. Awareness of government health programs was also moderately high (M = 2.68), yet formal communication and actual usage were low. Behavioral factors (β = 0.328, p = 0.002), workplace conditions (β = 0.305, p = 0.004), and financial accessibility (β = 0.320, p = 0.007) significantly influenced adherence. Demographic factors such as age, sex, tenure, and education were not significantly associated. Awareness was moderately correlated with adherence (ρ = 0.561, p < 0.001), but behavioral factors and support systems did not significantly moderate this relationship. Conclusions: While most employees with hypertension follow their medication regimen, barriers such as behavioral hesitations, workplace stress, and financial limitations reduce full adherence. This supports theoretical perspectives such as the Health Belief Model, emphasizing perceived barriers and cues to action. Findings underscore the importance of improving LGU program communication, strengthening workplace support, and addressing behavior-related barriers to enhance long-term hypertension management among working adults. From a policy perspective, workplace-based health promotion programs integrated with LGU services, such as orientation days and digital kiosks for medicine access, can support adherence.
The Relationship Between Family Functioning and Compassion Levels of BSN Students
Introduction: Compassion is an essential quality in Nursing, enhancing patient care, emotional well-being, and nurse-patient relationships. With increasing academic and clinical demands, it is important to understand what influences compassion among student nurses. Family functioning, which includes emotional support, communication, and adaptability, may play a role, although limited studies have examined its direct impact. Objectives: This study examined the relationship between family functioning and compassion levels among Bachelor of Science in Nursing (BSN) students. It sought to determine the family functioning and compassion levels, assess their differences across sex, year level, and type of educational institution, and evaluate their correlation. Methods: A quantitative descriptive-correlational cross-sectional design was utilized. Using stratified random sampling, 584 student nurses from two universities in Benguet were selected. Data were gathered from February to March 2025 using two standardized tools: the Family APGAR and the Compassion Scale. Statistical analyses included descriptive statistics, T-tests, one-way ANOVA, Tukey’s HSD, and Pearson’s Correlation. Results: Most students reported a high level of family functioning (Mean APGAR = 7.44). Significant differences were observed across year levels and educational institutions, but not by sex. Compassion levels were similarly high, with females demonstrating significantly higher scores. A weak yet significant positive correlation between family functioning and compassion levels was established, suggesting that stronger family support may enhance compassionate behaviors. Conclusion: This study emphasizes the influence of family functioning on the development of compassion in student nurses, highlighting the importance of supportive family environments in fostering emotional and professional growth. Future studies should consider longitudinal and mixed-method designs, broaden participant diversity, and examine additional factors such as mental health, socioeconomic status, caregiving experiences, and academic stress.
Exploring the Academic Journey of International Students in the Bachelor of Science in Nursing Program
Introduction: International student nurses who study abroad face various challenges. Existing studies regarding these are limited in scope. This study aims to explore the academic journey of international students, which is the totality of their experiences inside and outside their respective institutions. Objectives: To explore the academic journey of international students enrolled in the Bachelor of Science in Nursing Program in the Philippines and provide a holistic understanding of their journey. Methods: A descriptive phenomenological qualitative design was used, recruiting participants meeting the criteria: (1) students raised in a foreign country, (2) current citizens of a foreign country or with dual citizenship, (3) in the Philippines solely for education, (4) enrolled in a BSN program in the Philippines, and (5) with at least six months of residency in the Philippines. Eight informants were included, data were collected through semi-structured interviews, and analyzed using Colaizzi’s Phenomenological Data Analysis method. Rigor measures were utilized throughout the study process. Results: The study revealed four themes from the responses of the informants: (1) Flight of Discovery encapsulates their overall experiences in the Philippines. (2) Flight to Excellence delves into their diverse experiences in educational and clinical settings. (3) Flight into Socio-cultural Diversity focuses on their immersion into the Filipino community. Lastly, (4) Flight of Adaptation covers their self-help strategies as they traverse into a new environment. Conclusion: International student nurses in the Philippines encounter various experiences and challenges in their academic journey. Their experiences have led them to discover a variety of factors inside and outside their respective institutions that either enable or hinder them from adjusting to the new environment. These experiences require flexibility and adaptability to the educational processes and socio-cultural diversities
Factors Associated with Infection Prevention and Control (IPC) Practices among Primary Healthcare Nurses in Saudi Arabia
Introduction: Adequate training in infection prevention has been associated with improved knowledge and better practice adherence among nurses. This study aims to assess the factors associated with infection prevention and control (IPC) practices among primary healthcare nurses, providing a much-needed focus on this critical group within the healthcare system. Methods: This cross-sectional study assessed IPC practices among primary healthcare nurses in Aljouf City, Saudi Arabia, from March-April 2023, using a WHO-adapted questionnaire. Data were analyzed via descriptive statistics and multiple regression. This study was conducted with the approval of the University of Hail Institutional Review Board (H-2022-032). Results: Primary healthcare nurses demonstrated an “Advanced” overall level of IP practices (283/335), but the “Infection Control Programme” was at an “Intermediate” level (29.99).Tests of differences revealed no significant variations in IPC scores by age, gender, or nationality. However, significant differences were found by educational attainment (master's vs. baccalaureate, p=0.020), years of service (5-10 years vs. others, p=0.034), and IPC training (trained vs. untrained, p=0.028), with higher scores observed in nurses with master's degrees, 5-10 years of service, and IPC training. Multiple regression analysis confirmed these findings, indicating that educational attainment, years of service, and IPC training were significant predictors of IPC practice scores. Conclusion: This study highlights that primary healthcare nurses demonstrate advanced IPC practices, but the “Infection Control Programme” lags behind. Education, years of service, and training are key predictors of IPC proficiency, suggesting that interventions aimed at enhancing these areas will effectively improve IPC outcomes. These findings emphasize the need for continuous professional development and strategic program enhancements to ensure optimal infection prevention and control.
Resiliency of Community Health Nurses in Zamboanga City: Basis For Enhancement Program
Introduction: Community Health Nurses (CHNs) are crucial to primary healthcare but face resource shortages, heavy workloads, and health risks that may lead to burnout and attrition. Limited research explores factors affecting their resilience, particularly during health crises in Zamboanga City. Aim: This study aimed to explore the lived experiences of resilience among CHNs working in Zamboanga City. Methods: This qualitative study used a phenomenological approach to explore the lived experiences of resilience among ten CHNs in Zamboanga City, this approach provides an in-depth description on the challenges and resiliency of CHNs. Respondents were purposively selected from three health centers with at least one year of experience. Data were gathered via semi-structured interviews and analyzed using thematic analysis, guided by Van Breda’s Resiliency Model and Callista Roy’s Adaptation Model. Results: The study revealed that CHNs face multiple challenges—ranging from non-compliant patients and cultural barriers to resource shortages and emotional strain—especially during emergencies. In coping, they employed strategies aligned with Roy’s four adaptive modes, reflecting their capacity for self-care, professionalism, problem-solving, and reliance on social support. Conclusion: CHNs in Zamboanga city are resilient, effectively using coping strategies despite numerous workplace challenges. To enhance their resilience and to strengthen the healthcare programs, administrations, policies and healthcare services, adequate resources, continuing training, and institutional support must be provided among CHNs.
Structured Exercise among Pregnant Women during the Third Trimester
Introduction: Maternal mortality remains a significant concern in the Philippines, with a high maternal mortality ratio, emphasizing the need for effective interventions. This study investigated the level of awareness and extent of practice of structured exercises among pregnant women in Baguio City, Philippines. Methods: A descriptive correlational design was employed to investigate the level of awareness and extent of practice of structured exercises among 105 pregnant women in Baguio City. A convenience sampling was utilized to identify factors influencing exercise adoption and inform the development of culturally appropriate interventions aimed at improving maternal health outcomes. A validated questionnaire was used through “yes/no” responses and categorical scale with three response options, in determining the awareness and practice of various exercises. Data was analyzed using descriptive statistics, and simple linear correlation. Results: Findings revealed an overall moderate level of awareness (Mean Percentage Score = 49.31%) and practice (Mean Percentage Score = 1.99%) of structured exercise. Significant positive correlations were found between awareness and practice for several exercises, particularly those involving ankle and toe exercises, reflecting a direct translation of awareness into action. Educational attainment and the history of previous pregnancies positively influenced both awareness and practice, suggesting that prior experience and higher educational levels are associated with greater understanding of exercise benefits and increased self-efficacy. Conversely, engagement in exercises, such as abdominal and pelvic exercises, remained low, indicating an important area for intervention. This discrepancy accentuates the potential influence of perceived barriers, such as fear of complications and lack of access to resources, which outweigh perceived benefits. Conclusion: Further research is needed to assess the applicability of these findings across various populations and settings, as well as to evaluate the effectiveness of culturally tailored interventions aimed at overcoming the identified barriers. Ultimately, this research aims to contribute to broader strategies for reducing maternal mortality in the Philippines by promoting safe and effective exercise during pregnancy.
Prevalence of Bullying and Workplace Violence Against Nurses in Adult Health Units: Its Impact on the Mental Health and Job Productivity of Nurses
Introduction: This study seeks to investigate incidence rates of bullying as well as violence within designated adult health units while investigating correlated changes in mental health sequelae alongside productivity parameters. Methods: This study employed a descriptive-correlational approach among 121 nurses practicing in adult health units located in Cabuyao, Laguna, Philippines. Respondents were recruited through a convenience sampling method. Data collection was conducted utilizing three validated instruments: a 6-item adapted WHO/ILO/ICN/PSI questionnaire on workplace aggression, a 7-item adapted DASS-21 for mental health evaluation, and the NWFQ regarding productivity at work. The analysis involved computation of descriptive data, Chi-square tests, Spearman Rho correlation, and regression analysis on Jamovi Software for multivariable assessments between examined factors. Data collection was carried out over a six-week period from March to April 2025. Results: Despite a “Very Low” reported prevalence of workplace aggression (overall mean occurrence = 1.46, severity = 1.42), it had a statistically significant negative impact (p = 0.017) on nurses' mental health (depression, anxiety, and stress). Patients were the primary source of aggression (mean occurrence = 1.99), highlighting a critical issue. While overall mental distress is “Normal,” a “Low” score for “thinking about quitting because of stress/bullying” suggests underlying dissatisfaction. Crucially, workplace bullying and violence had a statistically significant negative effect on nurses' job productivity (β = -0.279, p = 0.032), and specifically, stress is significantly associated with lower job productivity (p = 0.009). Conclusion: Nurses reported “Very Low” levels of workplace aggression, particularly verbal abuse with patients as the primary perpetrators; even this minimal exposure significantly impacted their mental health (depression, anxiety, stress). Despite generally “Normal” mental distress, nurses frequently considered quitting due to workplace issues. Critically, overall “High” job productivity was negatively affected by workplace bullying and violence, with stress specifically linked to reduced productivity, suggesting an immediate detrimental influence on performance.
Impact of Excessive Online Health Searches on Parental Well-Being
Introduction: Technology transformed how parents access health information, but excessive online searches, or cyberchondria, can fuel reassurance-seeking and anxiety in managing family health. Demographic factors like age, education, socioeconomic status, and family structure shape vulnerability, yet their interplay with cultural beliefs remains understudied in Filipino contexts. This study examines the impact of excessive online health searches on parental well-being in the Philippines, aiming to address gaps in understanding digital health behaviors. Aim: This study aimed to determine the impact of cyberchondria on parental well-being, focusing on compulsion, distress, excessiveness, reassurance-seeking, mistrust, and thoughts, feelings, and behaviors. It analyzed how sociodemographic factors affect cyberchondria and well-being. The research also explored the relationship between cyberchondria and parental well-being. Methods: A quantitative correlational design explored the relationship between cyberchondria and parental well-being. Four hundred parents from 10 barangays in Baguio City were selected through systematic random sampling. Data collection utilized the Cyberchondria Severity Scale-15 and Health Anxiety by Proxy Scale. Descriptive and inferential statistics were applied. Ethics approval was granted by the REC on February 20, 2025 (Protocol No. SLU-REC 2025-047). Results: Cyberchondria results revealed parents were severely affected in Excessiveness and Reassurance-seeking; thoughts and behaviors showed high anxiety. Significant differences appeared in Age (cyberchondria) and Monthly Income (health anxiety). A moderate positive correlation showed that higher cyberchondria was linked to increased health anxiety by proxy. Conclusion: Cyberchondria diminishes parental well-being by fueling anxiety, reassurance-seeking, and reduced resilience. Anchored in Media Dependency Theory, findings support interventions and culturally adapted tools for responsible digital health-seeking.
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Musculoskeletal Disorders Among Traditional and Modern Jeepney Drivers: Prevalence, Location, and Severity Analysis
Introduction: Jeepneys are an essential form of public transportation in the Philippines. Drivers face occupational health risks, particularly musculoskeletal disorders (MSDs), influenced by multiple factors. Despite modernization efforts under the Public Utility Vehicle Modernization Program (PUVMP), MSDs continue to affect drivers, emphasizing the need for a comprehensive health assessment. Aim: The study aims to assess the prevalence, location, and severity of MSDs among traditional and modern jeepney drivers in Baguio City, and to investigate associations with age, number of hours driven, and years of experience. Methods: This study, guided by Neuman’s System Model, examined the prevalence, location, severity, and associated factors of musculoskeletal disorders (MSDs) among traditional and modern jeepney drivers in Baguio City. A cross-sectional analytic design was employed involving 113 male jeepney drivers recruited through stratified random sampling. Data were collected using the modified Extended Nordic Musculoskeletal Questionnaire (NMQ-E) to assess the prevalence, location, severity, and associations of MSDs with driver age, type of jeepney, hours of driving, and years of driving experience. Statistical analyses included chi-square, Fisher’s Exact, and Monte Carlo tests. Results: MSD prevalence was 56.6% (95% confidence interval, 47.5%-65.7%), with low back pain (33%; 95% CI: 25-42.4) being the most reported location. Severity varied, affecting functional abilities, although severe consequences, such as hospitalization, were rare. No significant associations were found between MSD prevalence, location, or severity and driver characteristics. These findings support a multifactorial etiology involving occupational exposures and individual factors. Conclusion: Nurses play a vital role in educating drivers on proper posture, encouraging regular health breaks, and promoting the use of simple, supportive aids to reduce MSD risk, especially during ongoing vehicle modernization. Immediate and practical nurse-led interventions can significantly improve driver well-being while vehicle modernization progresses. Future research may focus on longitudinal studies, workplace ergonomic assessment, and objective measurements of vibration exposure to better understand the progression of MSDs and support evidence-based interventions and policy development.
Quality of Life (QoL) Among Cancer Patients Undergoing Chemotherapy: A Concurrent Mixed Methods Approach
Introduction: Cancer continues to represent a critical global and national health concern, with profound physical, psychological, social, and environmental impacts on affected individuals. Aim: To explore the quality of life (QoL) of Filipino cancer patients undergoing chemotherapy across the four domains: physical, psychological, social, and environmental. Methods: A concurrent mixed-method triangulation design was employed, integrating quantitative and qualitative approaches. The quantitative phase used the WHOQOL-BREF to measure QoL, while the qualitative phase employed semi-structured interviews to capture patients lived experiences during chemotherapy. Results: Key findings indicated that physical QoL was moderate, with fatigue and treatment-related side effects as major concerns. Psychological and social QoL were rated high, supported by spirituality, family, and peer connections. Environmental QoL was also moderate, reflecting adequate living conditions and healthcare access, although financial burdens and logistical challenges, such as transportation, persisted. Quantitative analysis showed no statistically significant associations between QoL and demographic variables, including age, gender, marital status, educational attainment, region, cancer type, and treatment duration. However, qualitative findings revealed that these factors influenced individual experiences. Coping strategies such as acceptance, faith, and lifestyle adjustments fostered resilience, while emotional distress, reduced intimacy, and stigma remained challenges. These findings highlight the need for enhanced psychosocial support, financial assistance, and health education tailored to cancer patients in resource-limited settings. Conclusion: The study offers locally grounded insights into the multifaceted impact of chemotherapy, supporting the design of holistic care approaches and informed healthcare policies in resource-constrained settings. These findings can guide healthcare providers, caregivers, families, and policymakers in developing culturally sensitive, patient-centered interventions to enhance the quality of life of Filipino cancer patients.
From Sea of Emotions to Reflective Shores: The Lived Experiences of Nursing Students in the Context of Do Not Resuscitate Orders
Introduction: Involvement in Do Not Resuscitate (DNR) orders is a significant responsibility for student nurses, as it supplements the personal needs of patients to achieve a holistic quality of care. Student nurses often lack the necessary knowledge and experience in end-of-life care, leading to hesitation, discomfort, and even fear when faced with dying patients and dealing with ethical dilemmas. Methods: This phenomenological study explored the experiences of nursing students with patients with DNR orders to promote improved learning and assistance for future nursing students. This study comprises nine (9) participants from the Bachelor of Science in Nursing, including level 3 to 4 students of the University of the Cordilleras, selected through purposive sampling. An in-depth interview was utilized through face-to-face and virtual interviews. These participants were chosen following an inclusion and exclusion criterion. Data management commenced with the Colaizzi's seven (7) step phenomenological approach and management. Results: The analysis revealed four main themes — (a) Sea of Emotions, (b) Sailing Through Vocation, (c) Sudden Surges from the Depths, and (d) Reflective Shores of the Distant Beyond highlighting the (a) sadness and hesitance, (b) navigating responsibilities in patient care and competency development, (c) encountering communication barriers and ethical dilemmas, (d) recognizing the importance of professional preparedness and personal growth, and facing reality in handling DNR cases. Conclusion: Based on findings, it is concluded that the experience of student nurses with Do Not Resuscitate patients expressed a sea of emotions, including empathy, compassion, ethical dilemmas, and personal growth. The student nurses encountered sudden surges as they faced physical and emotional challenges, but despite that, they acted their roles as nurses in addressing the issues. Sailing through their vocation, the participants provided compassionate care, honoring patients' preferences, and supporting them in their final moments. The participants have been concerned with saving lives and respecting patients' autonomy as well as rendering care to the patients and their families. Furthermore, the participants' understanding of DNR orders delved into their knowledge, attitudes, skills, and values regarding end-of-life care decisions, having developed their improved and enhanced personal and professional views on DNR situations as they reflected on their experiences. It is recommended that continuous learning about end-of-life care and ethical dilemmas surrounding Do-Not-Resuscitate (DNR) orders should be encouraged among healthcare workers, with hospitals and schools facilitating discussions and collaboration among different healthcare professionals to ensure all perspectives are considered.
The Level of Cultural Competence of Nursing Students Among Nursing Schools in Baguio City
Introduction: Cultural competence enables nurses to provide culturally congruent care to various populations. As Baguio City is home to different ethnic and cultural groups, nursing students must develop this competence to meet the distinctive healthcare needs of multicultural and multiethnic communities. Despite integrating cultural competence into national nursing education standards, its actual implementation in curricula remains inconsistent and often insufficiently assessed. Moreover, empirical research in the Philippine context is limited, particularly in Baguio City. Aim: To assess the cultural competence level of nursing students in terms of cultural awareness, cultural knowledge, cultural sensitivity, and cultural practice and to identify significant differences on the cultural competence level based on year level and ethnic group. Methods: The study utilized a descriptive quantitative research design and was conducted across three universities in Baguio City. A total of 367 nursing students participated in the study, with 151 respondents from level 2, 124 from level 3, and 92 from level 4. Stratified and systematic random sampling were used to determine the sample size and to select the respondents. Data were gathered using the Cultural Competence Assessment Tool (CCATool), which was modified to suit the Philippine context. The data was analyzed using mean scores, standard deviation, Kruskal-Wallis Test, All Pair testing, and the Mann-Whitney U test. Results: Results showed that nursing students had a high level of cultural competence, particularly in cultural awareness, knowledge, and practice which is very high level. However, a significant gap was observed in the domain of cultural sensitivity, which scored notably lower than other domains. The analysis revealed significant differences in cultural competence across year levels, specifically in cultural awareness and cultural practice, with level 4 students revealed higher cultural awareness and competence, while level 3 students showed higher cultural practice. When grouped according to ethnic group, there is a significant difference in cultural knowledge and competence, with the Kankanaey being the highest. Conclusion: Level 2 to 4 nursing students from three universities in Baguio City generally provide adequate healthcare, including cultural beliefs, behaviors, and needs in patient care. They have an extensive awareness of their cultural identity and comprehensive knowledge of health beliefs, behaviors, power dynamics, and structural inequalities of different ethnic groups, and they apply these exceptionally in clinical practice. However, they partially recognize clients as equal partners, with some trust, acceptance, and respect in care. The year level and ethnic group of these students also affect their competencies in the four domains of cultural competence.
Effect of NursePlay in the Critical Thinking Disposition of Student Nurses
Introduction: The utilization of Virtual Gaming Simulation (VGS) intensified during the pandemic, which affected the critical thinking disposition of student nurses. With this, the NursePlay, a VGS was created. Aim: The study determined the effect of NursePlay on the critical thinking disposition of student nurses. Methods: A non-equivalent pre-test post-test control group design was employed with 44 BSN level 2 students in Baguio City, comprising 22 students in the intervention group and 22 in the comparison group. Fishbowl sampling was used. Both groups answered a self-made questionnaire with a CVI of 0.94 to measure the critical thinking disposition of the students. The weighted mean and repeated measures ANOVA were utilized. Results: The results revealed that student nurses possess an outstanding disposition in critical thinking, specifically in terms of maturity and innovativeness, while also demonstrating a very satisfactory disposition in critical thinking, particularly in engagement. Furthermore, the repeated measures ANOVA revealed that the within-subject effects of the interaction along the Overall Critical Thinking Disposition are significant (p 0.03 < 0.05). This indicates a significant difference between the mean scores from the pretest to the post-test in the control and intervention groups. Conclusion: Prior to NursePlay, student nurses have a pre-existing disposition towards critical thinking. NursePlay enhances the engagement and maturity disposition of student nurses, with a minimal effect on their innovativeness. The NursePlay’s features, such as time on task, feedback, virtual patient interaction, and design characteristics, effectively improve the student nurses’ critical thinking disposition, including their engagement and cognitive maturity.
Health-Related Quality of Life of Older Persons
Introduction: The proportion of people over 60 years is growing faster than any other age group. Increased longevity of older persons implies the need for attention and care as increasing age comes along with multiple health problems. Aim: To know the extent and perception of the health-related quality of life (HRQoL) of older persons in terms of: physical and mental health, social functioning, emotional well-being, and spiritual health. It aimed to look into the variables significantly related to the HRQoL of older persons, particularly: health status, age, ethnicity, religion, gender, financial status, social support, educational attainment, marital status, and employment. Furthermore, it aimed to develop a module to enhance the HRQoL of older persons. Methods: Mixed method sequential explanatory design was used. There were 382 and 16 respondents for the quantitative method and qualitative method, respectively. The sample size was computed using the Open Epi version 3.01. A self-made questionnaire and a semi-structured interview guide were used to gather data. Statistical tools were used to analyze the quantitative data, while Colizi was used for the qualitative data. Results: The extent of HRQoL of older persons in terms of physical and Mental health is (61.64), Social Functioning (22.71), and Emotional well-being (24.34) interpreted as good HRQoL mean scores, while Spiritual health has a fair (7.50) HRQoL mean score. On the variables significantly related to HRQoL of older persons, gender is significantly related to spiritual health with a p=value of 0.022; social support is significantly related to emotional well-being with a p-value of 0.038; and marital status is significantly related to spiritual health with a p-value of 0.007. The other variables are not significantly related to the HRQoL of older persons in the areas of physical and mental health, social functioning, emotional well-being, and spiritual health. Conclusion: The existential quality of life of older persons remains suboptimal despite satisfactory functioning in activities of daily living, cognition, socialization, and psychological well-being. The influence of variables differs by domain: formal education affects physiologic and cognitive wellness, social support enhances emotional well-being, and married male older persons demonstrate better spiritual contentment. An active aging module was developed to holistically enhance and sustain the health-related quality of life (HRQoL) of older persons.
Strengthening Long-Term Care for Bedridden Elderly: A Community-Driven Integrated Care Model in Thailand
. Introduction: Thailand is approaching super-aged society status, yet fragmented coordination and inadequate caregiver support hinder effective long-term care for bedridden elderly, particularly in rural areas. Aim: To develop and evaluate a community-driven integrated care model for bedridden elderly based on the Chronic Care Model (CCM). Methods: A three-phase mixed-methods study was conducted in rural Thailand: (1) situational analysis with 64 stakeholders, (2) participatory model development and expert validation, and (3) eight-month implementation with 25 bedridden elderly and their caregivers (January–August 2021). Results: The six-component model (health system organization, delivery system design, decision support, clinical information systems, self-management support, community engagement) achieved significant improvements across all indicators. Home visit coverage increased from 75% to 100%, satisfaction from 80% to 100%, and complications decreased from 70% to 40%. Timely referrals, screening, and standardized assessments all reached 100% (versus 65%, 65%, and 75% baseline). New complication prevention improved from 50% to 80%. Qualitative findings revealed enhanced caregiver confidence, reduced burden, and strengthened intersectoral coordination. Conclusion: The integrated care model effectively improved care quality for bedridden elderly in rural Thailand. Healthcare systems should adopt community-based models that leverage social structures and empower caregivers through systematic training. Policymakers should institutionalize care coordination mechanisms, allocate sustained funding, and formally recognize community caregivers as essential healthcare workforce members
Mountain Province State University (MPSU) Bachelor of Science in Nursing (BSN) Graduate Tracer Survey Uncovering Trends in Employment and Education Relevance
Introduction: This tracer study examined the licensure performance, employment outcomes, job relevance, and postgraduate engagement of Bachelor of Science in Nursing (BSN) graduates of Mountain Province State University (MPSU) from 2008 to 2024. Aim: Anchored on Employability Theory, the study aimed to determine how effectively the nursing program prepared graduates for professional practice and career development. Methods: Using a descriptive survey design, data were collected through a validated researcher-made questionnaire administered to randomly selected graduates across three curriculum groups: CMO 30 (2008–2016), CMO 14 (2017–2021), and CMO 15 (2022–2024). Reliability testing yielded a Cronbach’s alpha of 0.785, indicating acceptable internal consistency. Results: Findings showed a consistently high proportion of respondents who reported passing the Nursing Licensure Examination (NLE), with an overall respondent-based licensure rate of 96% that increased across curriculum groups (CMO 30: 94.9%; CMO 14: 96.8%; CMO 15: 98.3%). Employment outcomes revealed that 86.6% of graduates were currently employed, though recent graduates under CMO 15 exhibited lower employment rates and a higher proportion of those never employed. Job relevance remained high at 90.7%, yet CMO 15 showed the most notable decline. A strong shift toward local employment was observed, with 97.9% of the newest graduates working within the Philippines. Postgraduate engagement was low, with only 23.1% pursuing master’s studies and 1.2% enrolling in doctoral programs, primarily among CMO 30 graduates. Conclusion: The study concludes that the MPSU nursing program continues to produce competent graduates with strong licensure and employment outcomes, though emerging challenges among the newest graduates warrant timely institutional response. Results highlight the importance of ongoing curriculum review, strengthened school-to-work transition support, and expanded access to graduate nursing education. Establishing a Master of Arts or Master of Science in Nursing program at MPSU is recommended to promote lifelong learning and career advancement.
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Teaching Modalities in Nursing Education: Experiences, Challenges, and Coping Strategies of Educators During the COVID-19 Pandemic
Introduction: The COVID-19 pandemic forced university institutions across the globe to make a sudden transition into the realm of flexible learning. In the Philippines, such change presented peculiar challenges to nursing educators who had to preserve the quality of instruction even in the absence of face-to-face classroom interaction. Aim: This study explored the experiences, challenges, and coping strategies of nursing educators in the College of Nursing of a state university in Mindanao, Philippines, during the first semester of Academic Year (AY) 2020-2021. Methods: A qualitative phenomenological design was used to collect the data on eight participants in semi-structured online interviews and thematically analyze it within the six-step framework outlined by Braun and Clarke (2006). Following the ideas of the Transactional Model of Stress and Coping by Lazarus and Folkman (1984), the following three themes were identified: (1) navigating pedagogical disruption and cognitive-emotional adjustment, (2) enduring institutional and instructional strain in online nursing education, and (3) reframing stress through adaptation, empathy, and institutional support. Results: The results showed that although flexible learning first interfered with the conventional teaching habits, it also engaged educators in reflective adaptation, professional development, and resilience. Conclusion: The study highlights the need to have institutional empathy, fair digital infrastructure, and ongoing faculty training to maintain a vibrant and caring nursing education in a rapidly changing learning world.
Inter-Rater Agreement and Competency Gaps in QSEN: A Comparative Study of Student Nurse Self-Assessment and Nurse Educator Evaluation
Introduction: Integrating of Quality and Safety Education in Nursing (QSEN) competencies in nursing education aims to support advancing education in nursing as well as ongoing initiatives to improve and safeguard health care quality and patient safety. Aim: To determine the level of competencies of student nurses to policy guidelines on quality and safety education. Methods: The study utilized descriptive-comparative design, employing convenience sampling. It involves 213 Student Nurses and 83 Nurse Educators using a highly valid and reliable modified QSEN survey. This study was conducted at the University of Hail, Hail City, Saudi Arabias. Data collection was conducted from August 1 to September 30, 2024. Results: There is a very strong agreement (≈0.96) in ranking the competencies. While both groups rated to Teamwork and Collaboration as the highest competency, participants rated Evidence Based Practice (EBP), Informatics, and Quality Improvement (QI) as the lowest rated competencies. Most notably, it is only in the Patient Centered Care where a difference by one demographic (gender) is shown, as male (student nurses) respondents rated their competency higher (p = 0.032), and a substantial magnitude difference in EBP scores is observed (NE 2.93 vs SN 2.73) which indicates a gap in perceived confidence of the student. Conclusion: While student nurses and educators’ hand in hand recognize achievement across the six QSEN domains as confirming basic content mastery, the unrelentingly low scores in EBP, Informatics, and QI unquestionably warrant fundamental changes in the curriculum. These changes need to improve mastery in these areas, and more importantly, confidence evident in the EBP score gap so that graduates will be ready to practice with these skills.
Perfectly Imperfect: A Concept Analysis of “Wabi-Sabi” in Nursing
Introduction: This study explores “Wabi-Sabi,” a Japanese philosophical and aesthetic concept rooted in Zen Buddhism, which values beauty in imperfection, transience, and simplicity. The introduction highlights Wabi-Sabi’s contrast with perfectionism, its unique approach to mindfulness, holistic care, humanistic care, and resilience, and its relevance in challenging the medicalization of aging. Aim: To analyze Wabi-Sabi within Nursing, particularly how nurses can integrate and benefit from this philosophy to enhance well-being and patient care. Methods: The methodology employed Rodgers’ Evolutionary Concept Analysis. Data was collected from Google Scholar, EBSCO, Web of Science, PubMed, and Scopus, using keywords like “Wabi,” “Sabi,” and “Wabi-Sabi.” Inclusion criteria were English-language full-text articles and abstracts. The process involved identifying antecedents, attributes, and consequences of the concept, discerning related concepts, and developing model cases. Results: The results identified eight related concepts (e.g., mindfulness, holistic care) and six core attributes, including nurses’ acceptance of imperfection and appreciation of transience. Four antecedents (e.g., exposure to systemic “brokenness,” desire for deeper connection) and five consequences (e.g., enhanced nurse well-being, improved patient care) were also found. Conclusion: “Wabi-Sabi” offers a unique lens for nursing, promoting acceptance of imperfection and valuing the “brokenness” in human condition, healthcare systems, and professional knowledge. This approach fosters nurse resilience, self-acceptance, and improved interpersonal relationships, ultimately elevating person-centered care. Recommendations include integrating Wabi-Sabi into nursing education and practice, advocating for compassionate presence, humility, and valuing the imperfect journey of care.